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In early 2006, after years of progressively worsening chronic pain due to a damaged lower back, I had surgery to remove the lumbar disc at the L5/S1 level of my lower spine. The failed disc was replaced with a new device – a three-piece metal joint called the Kineflex Lumbar Disc – which was under FDA study as an alternative to fusing the two bones together.

The artificial joint, which is made of a strong, durable cobalt chromium alloy (and should last longer than I do, I am told) maintains the natural movement of the back and that joint, where a fusion locks that joint up and grows the two bones together into one. In theory, the result is better overall since a fusion results in transferring the load and movement (and resulting wear and tear) to the adjacent joints.

The stuff that didn’t work…

This all came to pass after repeated attempts at less-invasive therapy and surgical procedures. From medication to physical therapy, then on to anti-inflammatory steroid injections (hot topic these days) and surgical procedure called a microdiscectomy, the pros tried many different approaches (and I suffered through even more pain and troubles) before we eventually settled on serious surgery. And even then it was still a tough decision.

Looking back on it now, I really waited too long before pulling the trigger each step of the way. Too long to go to the doctor in the first place, too long to get the first steps of treatment, and too long to get to a spine orthopedic specialist. I was beyond miserable, barely able to get on my feet (and sometimes unable to get up off the floor). I was quite literally in constant pain, and my mind and body had compensated – as the brain tends to do – by tuning out all but the worst of it from conscious awareness. But pain is still pain, and the lack of sleep and physical consequences of always compensating for it were just too great and went on for too long. By the time I had the ADR surgery, it was well past time to do something.

The surgery…

My doctor – Dr. Reginald Knight, who I hear now practices medicine somewhere on the east coast – Was awesome. I went up to Seattle and met with him. He evaluated me and determined surgery was the best remaining option in my case. He offered up the medical trial device as an option to fusion of the joint. In fact, it was a lottery-style program: I would either get the Kineflex device or another artificial disc, and I would not know which until after the surgery (since they were randomly and blindly assigned).

It was a pretty heavy duty procedure, known as an anterior approach (good description here), which involved cutting me open below my belly button and moving all my guts and stuff out of the way in order to get access to my spine from the front. Then they cut the ligaments along the joint, removed the badly damaged disc (a shock-absorbing-like structure between the vertebrae) and replaced it with the artificial disc. That process consisted of cutting some slots in the bone, spreading the joint out, and sliding the new artificial joint in place. Then they sewed me back up.

As I wrote about at the time, the first few days were pretty rough. But quickly I started to heal and within a few weeks I was getting better and better. Within an month and a half, I was travelling internationally and was well on the way to being “normal” again.

Life after the surgery…

I wrote about my status a year later, and commented on how much better things had become. Since that time, my back has only improved. I regularly ski and do anything I want. In fact, 99% of the time I forget I have the artificial disc at all. For a year or so after the surgery I would get some odd joint clunks and pops, but over time my body has adjusted and anymore it’s just part of me. Everything else seems to have aligned and adjusted.

When doing heavy-impact sports, such as skiing on icy or very hard surfaces, the jarring motion on my back can cause some inflammation. I have to watch out for that. But it’s more of an aggravation than a problem. I just have to remember that there’s no more shock absorber there – It’s all hard metal now. Once a joint is damaged as badly as mine was, you’ll never be 100% better I think, but I am consistently 90-95% like new, and that’s something I’m grateful for.

Common questions…

There are a few things people ask me about regularly, so I’ll list those here with some answers.

Q:  How do you deal with airports? Do you set off metal detectors or get into trouble on those new millimeter-wave scanners?

A:  No problems at all. The metal is non-ferrous, so it doesn’t set off magnetic sensors, and the millimeter-wave scanners look at surface items, not into your body. So I’ve had no issues at all, not even once. And I fly commercially a lot.

Q:  What restrictions did your doctor place on you, and for how long?

A:  Now every patient will get specific instructions from his/her doc, but mine were clear: My doc told me that I had missed out on enough life, and that I needed to follow some common sense rules post-surgery about not bending over or lifting anything for a couple weeks (mostly aimed I think at making sure my incision healed without tearing), but within a few weeks he told me it was time to get out and do whatever I wanted. If it was uncomfortable, I’d know not to go there. But, he said, no restrictions (literally) and that was it. I took him at his word and went to Germany for work, where I climbed the 400+ stone steps to the Heidelberg castle and walked mikes and miles.

Q:  Have you placed any restrictions on yourself?

A:  Since the trip to Germany in 2006, I’ve done nothing but stay active with skiing, boating, jet skiing and a variety of other crazy, stupid activities. I did give up my motorcycle, however (the street bike, not the dirt bike hah – I still have that one!). I found that when I rode it I was focused on what could happen to my back if I was in a motorcycle accident. If that joint was damaged, fixing it would not be much of an option. I’d rather not take that chance and I found that the mental distraction was not exactly safe, either. So that’s the one thing I gave up. For now, anyhow. :)

Q:  Are there dangers and side effect of the surgery?

A:  All major surgery has risk. Anesthesia, bleeding problems – these are real any time someone goes under the knife. In particular this procedure has some risk related to blood vessel damage, since there are some key vessels to watch out for. In addition, there’s a risk of possible nerve damage that men especially should be aware of, since it can affect fertility and – well – let’s just call it “plumbing operations.” You can look it up if you like. Sometimes the damage is self-correcting over time, other times it’s permanent. Don’t avoid talking about the possible issues there. While it’s rare and occurs in a very small percentage of cases, once a guy is affected he is 100% affected - and probability just isn’t relevant at that point.

Past writings for people who are interested…

For people who are looking for information, or for anyone who cares to read back in time stalker-style (hah), I documented my surgery experience and early recovery, plus my one year results, here on this site:

I also documented the mess of different things the docs tried, but which failed – much of the stuff that led up to the major surgery:

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Kineflex Artificial Disc Surgery | Personal Stories
Friday, 26 October 2012 12:46:34 (Pacific Standard Time, UTC-08:00)
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On February 15th, 2006 I was wheeled into a surgical suite to have the intervertebral disc between the L5 and S1 vertebrae removed and replaced with a three-piece mechanical replacement joint. The Kineflex artificial disc was in FDA trials at the time, so I was a test subject for an all-metal design that was working its way to market. As of the time of this writing, it's still working though the approval process. If my own personal experience is Kineflex - High contrast side viewany indication of what ought to happen, then the Kineflex disc should be approved and shipped to the market as soon as possible. Granted, it's important that the device be used only where appropriate, but for people who today stand in the same shoes I wore up until a year ago, the artificial disc replacement (ADR) is a miracle, and can be a true life gift.

I have 15 degrees range of motion in the L5/S1 joint, which is excellent. My doctor told me at my one-year visit the other day that people with seven degrees or more range of motion are doing very well. So, that's good news. He's also very happy with the level of activity I have been able to take on since the surgery.

It's taken some time for me to get to where I feel pretty much "normal" (whatever that is). Shortly after my surgery I started to feel much much better. As time went on, I realized just how much pain I'd been in. And over the intervening months I have just gotten better and better. A couple weeks ago I went skiing with my friend up at Timberline on Mt. Hood, and was taking some of the smaller jumps without pain and without really even thinking (or at least without being concerned) about the fact that I have this metal contraption in my spine (and that, my friends, is the telling attribute of my experience).

The fact that there are days where I don't even think about my back is amazing. Who would have thought that I could go from being unable to sleep more than an hour or so at a time, and living with constant debilitating pain, to an active and almost pain-free person who can once again do almost anything I want. People who work with me and my friends can tell you how pathetic and practically crippled I was before surgery. Today they say I am a new person. When my doctor told me to go out and live my life, with no real restrictions (but to be sure to take good care of my back), I took him at his word. Nowadays I lift things the "right" way and I'm careful to respect what remains of my natural spine. But mostly I simply don't have to think about it too much.

The surgical procedure for ADR is a serious one, and not one to be taken lightly. Really, everything else should be tried before resorting to surgery of any kind. In my case they did injections, physical therapy, exercises, shrinking the disc in size... you name it. Even just medication. None of the other options helped. So, my choices were fusion of the two vertebrae or a prosthetic artificial disc replacement that was fairly new-fangled (at least in the United States, where many medical technologies actually get to market very late in the game).

I recently received an email from one of the creators of the Kineflex artificial lumbar disc, Malan de Villiers. That was cool, hearing from someone who actually designed the device that has changed my life so dramatically for the good.

I have my life back. That's something to be grateful for.

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Kineflex Artificial Disc Surgery | Personal Stories
Thursday, 15 February 2007 21:06:20 (Pacific Standard Time, UTC-08:00)
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If you're not into x-rays or thinking about surgery and stuff like that, you can just skip this one. Many people have had me promise to show them pictures of the artificial disc that was implanted in me three months ago once I got them, so - well - here you go. This is a pretty amazing and relatively new (in the USA anyhow) area of medicine.

The Kineflex artificial lumbar disc is a three-piece metal-on-metal mechanical replacement, which is used to treat chronic and severe lumbar pain due to degenerative disc disease. It's in FDA trials right now, which makes me a bit of a guinea pig. It's not the kind of surgery you decide to do without a lot of serious thought and only after trying every other option. It replaced my natural disc, and now my severe back and leg pain that I lived with 24 hours a day for years is practically gone - and as a bonus I am a little bit taller than I was before the surgery. As I've said here before, I have my life back thanks to the doctors and the people that built this little device.

How'd they get it in there? The made an 8-inch horizontal incision just below my belly button (yep, they approach the spine from the front), spread the bones apart, removed the disc that was damaged, and put this new one in place.

You can click each image to view them larger-sized. I've removed any sensitive personal information.

Kineflex - High contrast side view

Kineflex - Reverse image high contrast

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Kineflex Artificial Disc Surgery | Personal Stories | Random Stuff
Sunday, 21 May 2006 23:58:57 (Pacific Standard Time, UTC-08:00)
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It's been seven weeks since I underwent surgery on my lower back up near Seattle, Washington. I was the recipient of a Kineflex lumbar artificial disc, a three-part, all-metal mechanical replacement for the torn, herniated and collapsed (degenerated) disc between my L5 and S1 vertebrae. That's the lowest one in your spine.

This surgery has truly given me my life back.

Before the procedure, I was always - and I quite literally mean always - in pain. Real pain, the kind that wears you down every minute of every day. The kind of chronic pain that people can't fully understand until they've lived with it themselves. It wears you down, chews you up, and eventually spits you out. "Normal" for me was a lot like the "normal" road noise is for someone who lives right next to a freeway: Spend your whole life around it and your brain tunes it out just to cope, but it's always there. Sure, louder noises still annoy you, but the mind has a way of coping with whatever you throw at it, at least as best it can. But that background pain still has an effect, progressively more so over time. When the sound is gone, it's almost deafening. And when the pain is gone, you finally realize just how bad it's been.

I feel ten times better than I've felt in more than ten years. Seriously.

Yeah, I am a guinea pig of sorts - the artificial disc I was fortunate enough to receive was provided to me as part of an FDA trial - not very many people have this hardware in their bodies. I did more than a year of careful and critical research on artificial disc surgery before I decided to take the leap. I considered bone fusion (which is the classic and most common treatment for my condition) and I tried every other treatment that was available to me - physical therapy, exercise, medicine, cortisone injections, minimally invasive procedures, you name it. When it came down to it, it was a choice between bone fusion or ADR (artificial disc replacement) procedure. the ADR device allows the joint to remain mobile instead of locking it up permanently, and I am only 38 years old (well for a few days anyhow), so staying mobile is  important to me. Because I had a 50/50 chance of receiving either a Charite or Kineflex artificial disc (they split the patients randomly, half and half), I also had to become confident in both technologies (the Charite is two metal plates with a plastic core, while the Kineflex is the same basic idea, but with a different design and a metal core). I can tell you that I was lucky and got the one I really wanted (the Kineflex), but either would have been okay with me.

Not everyone is the same, and surgery is rough stuff. The procedure is a serious one with potential side effects that one has to be ready to accept. Everyone's body is different and surgery is in large part an art, which means they all go slightly differently. Many people benefit from the new technology, while some are not so fortunate. That said, I am so grateful for my decision and to my doctors and the staff that have given me so much back. I did not fully realize how bad off I was until now, and still each day I keep feeling better. It will likely be many months before I can say I am healed and recovered, but I can see and believe that day's coming, which is something I had almost given up hope on before.

I write this from what used to be one of the most painful places in my life: An airliner seat at 37,000 feet. And guess what?

It doesn't hurt anymore.

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Kineflex Artificial Disc Surgery | Personal Stories
Tuesday, 04 April 2006 19:04:08 (Pacific Standard Time, UTC-08:00)
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If the knife doesn't kill me, the stress just might... On Wednesday at around 7am I'll be up in the Seattle area on a table in a surgical suite, and with any luck about an hour and a half (or so) later I'll be hallucinating and stuff in the recovery room as the proud and successful recipient of a artificial disc replacement at the L5/S1 joint in my lower back. I get to lay around in a hospital bed for a couple/few days, then can head home to lie around a whole lot more.

It's not quite Steve Austin style stuff, but the plan is to replace a collapsed, herniated and generally failed lumbar disc with a mechanical replacement. I'll be like a scaled-down version the bionic man. Not quite six million dollars worth of work (more like in the tens of thousands), but I am told they can rebuild me, they have the technology.

MRI picture from a while backTruth be told, I'm just a bit scared. I've never been through surgery anywhere near this extensive before, and the decision to do this has been a long and tedious process involving a lot of risk and personal decisions. In the past I've had epidural injections of cortisone, lots of physical therapy, a minimally-invasive microdiscectomy surgical procedure, more physical therapy, medication, rest, exercise, you name it. But when a body part's shot, it's just shot.

Since then I decided - after meeting with a few highly regarded and experienced surgeons who told me I'm just delaying the inevitable fusion or artificial disc surgery - to stick it out for a while and see if I could just deal with the pain. The problem is, in order to do that I've had to keep myself from doing a lot of the things one needs to do in a normal life from day to day, as well as a lot of the things that help make life enjoyable, and that's no good.

So, here I am. Surgery could mean a great improvement in my quality of life. Of course it's not without risks (you really want someone operating on your spine?), and the past year has been mostly about deciding whether the risks of the procedure are worth the potential benefits and avoiding surgery. The pain has not improved much if at all, it always limits me, and at many times it's quite unbearable. Life's no good like this. So, it's time. My doctor is very experienced and I have lots of confidence in him. The facility is great. No more excuses.

As always seems to happen (Ask Murphy why, I sure there's a law about it), workplace and life situations, stresses and pressures are coming to a head right about the time I have to do this surgery, but I've decided that I really only get one life, and one body for that life. Jobs are something that can flex and be molded and true friends will wait, so while I'm wanting to get back to work and life as soon as it's realistic, I have to take care of this other stuff first, slow and steady as they say.

But I'm not just worried and scared. I'm also excited. The prospect of healing and being able to do many of the things I used to take for granted is truly something to look forward to - things like loading the trash cans into the truck to take to the dump, or walking the dog more than a quarter mile, or riding a bike or my motorcycle, or sitting in a chair for more than 15 minutes at a time, or even just being able to pick things up off the floor. 

That and not falling flat on my face in the hallway because I twist or step the wrong way, or because I drag my leg and pain shoots out my foot - That's just one of many things I am looking forward to no longer experiencing.

Anyhow, It'll be lighter than usual posting here probably for a little while 'til this is behind me. Maybe a little bit more to write over the next couple days, but come Wednesday I think I'll be rather out of it. Cross your fingers for me.

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Kineflex Artificial Disc Surgery | Personal Stories | Random Stuff
Sunday, 12 February 2006 13:30:38 (Pacific Standard Time, UTC-08:00)
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Life, work and everything else is pretty crazy these days. I'm tentatively scheduled for some major surgery on my lower back in February, and my day (and evening) job is hectic and quite challenging in many ways (but I'm not complaining). Add everything else that happens in life into the mix, well... Recently it's been just a bit overwhelming at times.

I've traveled more than usual lately. One of the things I found made it more bearable (besides wearing my rigid back brace on airplanes - thank goodness for that stupid thing) is the new iPod video model I recently picked up. I discovered Battlestar Galactica, the revived show that everyone and their brother has apparently seen and raves about. Now I can see why they rave. I used to watch the original series when I was a kid - it was the greatest show on TV for a period of time, at least in my book. So, I purchased the pilot mini-series of the new, modern version via iTunes a couple weeks ago and watched it on my flights to Philly and Pittsburgh. What a great show. Definitely made a couple long flights much more sane. I downloaded the first season of the show the other night and will start watching that soon.

Some of you know I've had back problems for some time. I now have back surgery set for February 15th in Seattle. There are some tests that I have to get done before then, too (bone scan, labs, etc.). From what the doc says, I guess I will be relatively out of it for a while - at least a few weeks. It's quite an intimidating prospect, actually: I have never had major surgery before, so I am more than just a little nervous, even though the doc is terrific and has tons of experience. More on that later, maybe when the day gets closer. Afterward it will certainly make for an interesting and geeky bionic-man kind of tale, assuming all works out and the surgery actually happens. First things first.

Have you ever had major surgery? Care to share your experience? Mine will be an anterior (read: from the front) approach to the lumbar spine (at L5-S1), where they'll remove the disc and then do their handiwork. Not too common, but maybe there's someone else out there who's been through that sort of thing. If so, let me know.

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Kineflex Artificial Disc Surgery | Personal Stories | Random Stuff
Monday, 23 January 2006 18:30:48 (Pacific Standard Time, UTC-08:00)
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Greg Hughes is a high-tech executive working in the Security and Information Technology fields. He lives near Portland, Oregon in the United States and grew up in the high-tech town of Los Alamos, New Mexico.

After working seven years in photojournalism, he shifted gears and became a police officer. After another seven or so years of being paid small money to take big risks and deal with mean people, he made the bold move to become a professional computer geek.

Without a regular dose of police adrenaline comes a desire to continue to find new ways to walk out there "on the edge," so now he also blows things up as a hobby. Not a bad way to have some fun, when you consider someone else pays thousands of dollars to buy the materials and you get to blow it up. "Win-win," as they say. Recently he also became a pilot and bought a used airplane for a great deal, so on a nice evening or weekend he might be found up in the air defying the laws of logic and leveraging the laws of physics.

These day's Greg is involved in some stuff he can't talk too much about, but it is security related and it's quite enjoyable. His recent work as the Chief Security Executive and VP of Security and IT at the world's leading online banking company allowed him to combine the managing and building complex and important technology with forensics and investigation, and his personal weblog (which you're reading now) combines security and technology with some personal thoughts and experiences.

People who meet him often wonder how he has managed to pack so many experiences into his life. When it comes down to it, Greg is one of those guys who doesn't want to miss out on all those things that most people dream of. Whether it's helping catch cyber-criminals, skydiving, blowing things up, teaching, working with at-risk kids, climbing mountains, catching bad guys, riding motorcycles, hauling up and down the river in a jet boat or on a jet ski, or being the halftime highlight on Sports Center because some lanky basketball player crushed him while he was shooting pictures on the court, there's a decent chance he's done it - because hey, life is all about the experience.

His friends say Greg is a kind, patient and pretty darned decent human being. I guess he's got them fooled! He's been a foster parent for 14 at-risk and special-needs kids, as well as a cop, photographer, skiier, geek, student, movie theater projectionist, paperboy, bakery cleaner, skydiver, camera salesman, volunteer, bionic man, pyrotechnician, pilot, wannabe snowboarder (retired), friend, and a whole slew of other things.

It should be noted that he is not the same Greg Hughes of Opie and Anthony fame, and he's not the same Greg Hughes who works for another security company called Symantec, and he's not the same Greg Hughes who wrote the iPhone program called Wifi-Sync. He's also not the state politician from Utah. Those are all other guys. Who knew there were so many Greg Hugheses out there?

Want or need to reach Greg?

Or, if I am online now on Live Messenger, you can chat with me here:

If you want to keep track of whatever Greg writes on this weblog, there are a couple ways you can do just that:

  • If you use MSN Messenger, sign up for .NET alerts, which can be delivered to your Messenger program and/or mobile device. Click this button to start:
  • Use an RSS aggregator program like FeedDemon (or any feed-reader you like) to subscribe to Greg's RSS 2.0 feed (click the little button to access the feed).
  • Visit this web site by typing in your web browser's address bar.

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Personal Stories | Random Stuff
Friday, 05 September 2003 22:42:14 (Pacific Standard Time, UTC-08:00)
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